Comparison of in vitro assay for specific IgE and skin prick test with intradermal test in patients with allergic rhinitis.

ABSTRACT

Among many diagnostic tests for allergic rhinitis, the intradermal (ID) test is practical and reliable. However, there are several factors affecting compliance, practicability and interpretation, and also problems on hypersensitivity of the ID. For these reasons, we evaluated other tests which have been thought to have high reliability as diagnostic and/or screening assays, namely, skin prick test and specific IgE detection in seventy-four perennial rhinitis patients (51 males and 23 females whose ages were between 15-60 years). In this study, Dermatophagoides pteronyssinus and D. farinae extracts, known to be the most common aeroallergens in Thailand, were used as the allergens/antigens. Compared to the standard ID test, sensitivities to D. pteronyssinus and D. farinae of the studied patients tested by skin prick test were 90.4% and 86.4%, and specificities were 99.5% and 93.1%, respectively. Sensitivities to D. pteronyssinus and D. farinae using specific IgE assay were 96.3% and 88.9%, and specificities were 96.2% and 88.9%, respectively. It was concluded that the skin prick test can be used as a screening method for patients with allergic rhinitis, while the specific IgE detection can be used as an alternative for diagnosis of patients who are susceptible to the ID test or for those who are severely susceptible to allergic rhinitis such that medication can not be withdrawn for the ID test.